Objective: This research aims to describe the profile, clinical course, treatment and outcome of varicella in immunocompromised children at the Philippine General Hospital from January 1999 to December 2004.Study Population: All immunocompromised patients less than 19 years of age with a clinical diagnosis of varicella admitted at the Philippine General Hospital during the study period were included. Method: A review of medical records and monthly census reports of the Pediatric Infectious Disease and Hematology-Oncology Services was conducted. Results: Out of 26 immunocompromised patients who developed varicella during the study period, only 22 charts were available for review. Of these patients, 13 were male and 9 were female. The highest incidence occurred from 0 to 5 years old (41%). Twenty patients had an underlying malignancy in the form of leukemia (14%) and solid organ tumors (6%). Two patients were on chronic steroid therapy (Prednisone) for more than a month due to Nephrotic Syndrome and Myelodysplastic Syndrome with Stevens-Johnson Syndrome. The most common presenting symptom was a rash (68%), with an associated fever seen in 54% of the cases. Majority were treated with acyclovir for an average of 7 days with good response. Nine patients developed complications: mainly, pneumonia and sepsis. Recovery rate was 82%; however, fatality rate was 13.6%. Conclusion: Varicella in immunocompromised children is associated with increased morbidity and mortality. Our patients responded well to sequential intravenous and oral acyclovir. Vaccination of targeted populations such as close household contacts of immunocompromised patients, as well as, healthcare workers may be a good strategy to protect high-risk children from developing the disease and its complications.
Human ; Male ; Female ; Adolescent ; Child ; Child Preschool ; Infant ; Infant Newborn ; CHICKENPOX ; IMMUNOCOMPROMISED HOST ; NEOPLASMS ; ACYCLOVIR

Introduction: Ciguatera fish poisoning (CFP) is common in tropical and subtropical waters. On 13 November 2015, eight Filipino seafarers from a cargo ship sailing in the Caribbean Sea experienced a range of symptoms after consuming a barracuda. Upon their return to the Philippines, an investigation was conducted to describe the cases. Methods: A case-series was conducted. A CFP case was defined as a previously well individual on the ship who developed at least one gastrointestinal symptom and at least one neurologic manifestation after eating barracuda on 13 November 2015. All cases were admitted to hospital in Manila, Philippines and were interviewed using a standard questionnaire. Urine and serum samples of cases were collected for ciguatoxin (CTX) testing by radiological and receptor-binding assay. Results: Eight of the 25 seafarers on the ship ate the barracuda; all eight met the CFP case definition. The age of cases ranged from 37 to 58 years (median: 47 years) and all were males. Onset of symptoms ranged from 1 to 3 hours (median: 2 hours) from the time of ingestion of the barracuda. All cases experienced gastrointestinal (nausea, vomiting, diarrhoea) and neurologic (temperature allodynia, itchiness) symptoms but no cardiovascular manifestations. Urine and serum specimens of all eight cases showed CTX below the detection limit. Discussion The Philippines Epidemiology Bureau recommended that the Philippine Maritime Authority include CTX poisoning and its health risks in seafarers’ training to prevent future cases of CFP. The Event-based Surveillance and Response system will continue to provide a mechanism for the reporting and appropriate management of CFP cases.

Obesity is a major worldwide health problem that is related to most chronic diseases, including male infertility. Owing to its wide impact on health, mechanisms underlying obesity-related infertility remain unknown. In this study, we report that mice fed a high-fat diet (HFD) for over 2 months showed reduced fertility rates and increased germ cell apoptosis, seminiferous tubule degeneration, and decreased intratesticular estradiol (E2) and E2-to-testosterone ratio. Interestingly, we also detected a decrease in testicular fatty acid levels, behenic acid (C22:0), and docosahexaenoic acid (DHA, 22:6n-3), which may be related to the production of dysfunctional spermatozoa. Overall, we did not detect any changes in the frequency of seminiferous tubule stages, sperm count, or rate of in vitro capacitation. However, there was an increase in spontaneous and progesterone-induced acrosomal exocytosis (acrosome reaction) in spermatozoa from HFD-fed mice. These data suggest that a decrease in E2 and fatty acid levels influences spermatogenesis and some steps of acrosome biogenesis that will have consequences for fertilization. Thus, our results add new evidence about the adverse effect of obesity in male reproduction and suggest that the acrosomal reaction can also be affected under this condition.